Foundations of Clinical Nurse Specialist Practice

2014 AJN Book of the Year Award Winner in Advanced Practice Nursing, First Place

Designated a Doody's Core Title!

"This widely acclaimed resource has been improved with this update. It is an excellent addition to the library of clinical nurse specialist students, faculty, and current practitioners. The release of the second edition ensures that the information is current for the ever-changing healthcare environment." Score: 100, 5 stars

Now in its second edition, this highly acclaimed text remains the only cohesive, comprehensive textbook and professional reference for CNS education and practice. Supported by theory, research, and current literature, the text focuses on CNS roles and scope of practice, expanding opportunities in primary and home care settings, and on outcomes of CNS practice across the care continuum. This second edition reflects two emerging trends affecting CNS practice: an increased focus on transitional care (continuity across the care setting continuum) and new Centers for Medicare Services reimbursement rules related to pressure ulcers, fall and infection prevention, and pain management. Additionally, the second edition places increased emphasis on CNS practice outcomes and newly emerging roles in chronic illness management in primary and home care settings.

Contributors to this edition represent the ìWhoís Whoî of CNS Nursing. Outstanding features include text boxes throughout that highlight core competencies and practice outcomes identified in NACNSís Statement on Clinical Nurse Specialist Practice and Education. Additional chapter features include discussion questions, analysis and synthesis exercises, and clinical application considerations. The text also contains four models of CNS specialty care, and 10 exemplars of CNS practice, all including outcomes.

New to the Second Edition:

• Increased focus on transitional care, primary care, program evaluation, and opportunities for CNS within the ACO and Medicare
• Emphasis on CNS role and practice outcomes pertaining to care of pressure ulcers, fall and infection prevention, and pain management
• New chapter on Program Evaluation
• New chapter on Affordable Care Organizations: New Horizons for CNS Practice
• New chapter on economics of CNS practice
• New chapter on CNS in primary care

Contributors ix

Foreword xiii

Preface xv

Acknowledgments xvii

UNIT I. THE NATURE OF CLINICAL NURSE SPECIALIST

PRACTICE

1. Evolution of the Clinical Nurse Specialist Role

and Practice in the United States 1

Janet S. Fulton

2. Professional Attributes in the Context of

Emotional Intelligence, Ethical Conduct, and

Citizenship of the Clinical Nurse Specialist 17

Janet M. Bingle and Sue B. Davidson

3. Philosophical Underpinnings of Advanced

Nursing Practice: A Synthesizing Framework for

Clinical Nurse Specialist Practice 33

Frank D. Hicks

4. Nurse-Sensitive Outcomes 41

Diane M. Doran, Souraya Sidani, and

Tammie DiPietro

UNIT II. DESIGNING AND EVALUATING NURSING

INTERVENTIONS

5. Clinical Reasoning Model: A Clinical Inquiry

Guide for Solving Problems in the Nursing

Domain 65

Brenda L. Lyon

6. Managing the Change/Innovation Process 81

Jeannette Richardson

7. Evaluating Interventions 97

Kelly A. Goudreau

UNIT III. PROMOTING INNOVATION, CHANGE,

AND DIFFUSION IN PRACTICE

8. Using Complex Adaptive Systems Theory to

Guide Change 109

Kathleen Chapman

9. Engaging Staff in Learning 123

Christine M. Pacini

10. Shaping Practice: Evidence-Based Practice

Models 145

Lisa Hopp

11. Transformational Leadership as the Clinical

Nurse Specialistís Capacity to Influence 163

Brenda L. Lyon

12. Creating a Culture of Quality 173

Nancy Benton

13. Patient Safety 183

Patricia R. Ebright

UNIT IV. DELIVERING CARE TO CLIENTS

14. Individual as Client 199

Janet S. Fulton and Carol L. Baird

15. Family as Client 215

Barbara S. OíBrien, Ginette G. Ferszt,

Cheryl L. Crisp, and Desiree Hensel

16. Community as Client: Clinical Nurse Specialist

Role 231

Naomi E. Ervin

17. Population-Based Data Analysis 241

Ann L. Cupp Curley

18. Client-Focused Teaching and Coaching: The

Clinical Nurse Specialist Role 255

Kelly A. Goudreau

UNIT V. THE BUSINESS OF CLINICAL NURSE

SPECIALIST PRACTICE

19. Consultation in the Clinical Nurse Specialist

Role 269

Geraldine S. Pearson

20. Mentoring 277

Kelly A. Goudreau

21. Project Management: A Core Competency for

Clinical Nurse Specialists 287

Stacy Webster-Wharton and Kelly A. Goudreau

22. Program Evaluation and Clinical Nurse

Specialist Practice 295

Jane A. Walker

23. Accountable Care OrganizationsóNew

Horizons for Clinical Nurse Specialist

Practice 309

Kimberly S. Hodge, Courtney Federspiel, and

Janet S. Fulton

24. Economic and Financial Considerations for

Clinical Nurse Specialists 319

Mary L. Fisher, Leeann Blue, Lori D. Stark, and

Jan M. Powers

25. Technology Management in Complex Health

Care Settings 331

Patricia OíMalley

26. Entrepreneurship and Intrapreneurship in

Advanced Nursing Practice 345

Maria R. Shirey

27. Regulatory and Professional Credentialing of

Clinical Nurse Specialists 363

Brenda L. Lyon

28. Student Clinical Experiences: Responsibilities of

Student, Preceptor, and Faculty 373

Florence Myrick and Diane Billay

UNIT VI. CLINICAL NURSE SPECIALIST ROLE IN A

VARIETY OF SETTINGS

29. Hospital-Based Clinical Nurse Specialist

Practice 391

Ginger S. Pierson

30. Clinical Nurse Specialist in Collaborative

Private Practice 397

Jeffrey S. Jones

31. Clinical Nurse Specialist Entrepreneurship: A

Journey From Idea to Invention, Leading to

Consulting/Education Business 403

Kathleen M. Vollman

32. The Clinical Nurse Specialist in Industry/

Business 411

Jane L. Bromund, Mary A. Short, and

Kathleen C. Solotkin

UNIT VII. EXEMPLARS OF CLINICAL NURSE

SPECIALIST PRACTICE IN A VARIETY OF SPECIALTY

AREAS

33. Providing Pediatric Palliative Care in a Regional

Childrenís Medical Center 417

Patricia OíMalley

34. Implementing a Comprehensive Bariatric Care

Protocol 421

Kathleen D. Wright

35. Reducing Central LineñAssociated Bloodstream

Infections Through a CNS-Led Systemwide

Approach 427

Mary Pat Johnston

36. Improving Clinical Care for a Specialty Surgical

Oncology Population 433

Colleen OíLeary and Taletha M. Askew

37. Facilitating a Programmatic Approach

to Children With Special Health Care

Needs 435

Jo Ellen Rust

38. The Clinical Nurse Specialist in Primary Care

Jeannette Richardson 439

39. Growing a Clinical Nurse Specialist Practice in a

Rehabilitation Setting 451

Kathleen L. Dunn

40. Exploring Clinical Nurse Specialist Practice in

the Emergency Department 457

Garrett K. Chan

41. Establishing a Private Practice for Diabetes

Self-Management 463

Patricia S. Moore

42. Rapid Response Exemplar: Maturation

and Refinement of a Rapid Response

Program 469

Tracey Loudon and Victoria Church

Appendix: Specialty Practice Organizations in

Nursing 479

Michelle L. Treon and Diana Jones

Index 487